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International Journal of Hepatology
Volume 2011, Article ID 398291, 5 pages
http://dx.doi.org/10.4061/2011/398291
Review Article

Role of TIPS in Improving Survival of Patients with Decompensated Liver Disease

1Department of Radiology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433
2Department of Gastroenterology, Bombay Hospital, 12 Marine Lines, Mumbai 400020, India

Received 26 February 2011; Accepted 13 April 2011

Academic Editor: Richard Guan

Copyright © 2011 Sundeep J. Punamiya and Deepak N. Amarapurkar. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Liver cirrhosis is associated with higher morbidity and reduced survival with appearance of portal hypertension and resultant decompensation. Portal decompression plays a key role in improving survival in these patients. Transjugular intrahepatic portosystemic shunts are known to be efficacious in reducing portal venous pressure and control of complications such as variceal bleeding and ascites. However, they have been associated with significant problems such as poor shunt durability, increased encephalopathy, and unchanged survival when compared with conservative treatment options. The last decade has seen a significant improvement in these complications, with introduction of covered stents, better selection of patients, and clearer understanding of procedural end-points. Use of TIPS early in the period of decompensation also appears promising in further improvement of survival of cirrhotic patients.